Infection Prevention Manual

The following performance indicators are recommended for measuring improvements in HCWs’ handhygiene adherence: A. Periodically monitor and record adherence as the number of hand-hygiene episodes performed by personnel/number of hand-hygiene opportunities, by ward or by service. Provide feedback to personnel regarding their performance. B. Monitor the volume of alcohol-based hand rub (or detergent used for handwashing or hand antisepsis) used per 1,00 patient-visits. C. Monitor adherence to policies dealing with wearing of artificial nails. D. When outbreaks of infection occur, assess the adequacy of health-care worker hand hygiene. WORLD HEALTH ORGANIZATION (WHO) GUIDELINES Factors affecting adherence to Hand Hygiene: Factors that may influence hand hygiene include risk factors for non-adherence identified in epidemiological studies and reasons reported by HCWs for lack of adherence to hand hygiene recommendations. Risk factors for poor adherence to hand hygiene have been determined objectively in several observational studies or interventions to improve adherence. Included professional category, time of day/week, and type and intensity of patient care, defined as the number of opportunities for hand hygiene per visit of patient care. Perceived barriers to adherence with hand hygiene practice recommendations include skin irritation caused by hand hygiene agents, inaccessible hand hygiene supplies, interference with HCW–patient relationships, patient needs perceived as a priority over hand hygiene, wearing of gloves, forgetfulness, lack of knowledge of guidelines, insufficient time for hand hygiene, high workload and understaffing, and the lack of scientific information showing a definitive impact of improved hand hygiene on HCAI rates. Lack of knowledge of guidelines for hand hygiene, lack of recognition of hand hygiene opportunities during patient care, and lack of awareness of the risk of cross-transmission of pathogens are barriers to good hand hygiene practices. Furthermore, some HCWs believed that they washed their hands when necessary even when observations indicated that they did not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¶ KDQGV 5RXWLQH REVHUYDWLRQ DQG IHHGEDFN 5HPLQGHUV LQ WKH ZRUNSODFH VWDII GRFXPHQWDWLRQ HGXFDWLRQDO PDWHULDO ,PSURYH $JHQF\ VDIHW\ FOLPDWH 3URPRWH DFWLYH SDUWLFLSDWLRQ DW LQGLYLGXDO DQG $JHQF\ OHYHO $YRLG RYHUFURZGLQJ XQGHUVWDIILQJ H[FHVVLYH ZRUNORDG ,QVWLWXWH DGPLQLVWUDWLYH VDQFWLRQ UHZDUGLQJ (QVXUH SDWLHQW HPSRZHUPHQW Your Agency Name (PN System)